Medical diagnosis: are expert systems needed?

An evaluation of the pitfalls of computer-aided diagnosis during the last ten years seems to show that increased emphasis on real clinical problems as well as increased use of medical knowledge are required. Since such an approach could fit into the 'expert system' framework, one should expect new developments in that research field to occur soon. However, expert systems can also be designed along the same concepts as previous models of diagnostic reasoning presumably with the same shortcomings.